Chapter XXXI.

Chapter XXXI.Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains.Of Swoonings.Sect.494.There are many Degrees of Swooning, or fainting away: the slightest is that in which the Patient constantly perceives and understands, yet without the Power of speaking. This is called a Fainting, which happens very often to vapourishPersons, and without any remarkable Alteration of the Pulse.If the Patient entirely loses Sensation, or Feeling, and Understanding, with a very considerable Sinking of the Pulse, this is called aSyncopè, and is the second Degree of Swooning.But if thisSyncopèis so violent, that the Pulse seems totally extinguished; without any discernible Breathing; with a manifest Coldness of the whole Body; and a wanly livid Countenance, it constitutes a third and last Degree, which is the true Image of Death, that in Effect sometimes attends it, and it is called anAsphixy, which may signify a total Resolution.Swoonings result from many different Causes, of which I shall only enumerate the principal; and these are, 1, Too large a Quantity of Blood. 2, A Defect or insufficient Proportion of it, and a general Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous Maladies. 5, The Passions; and, 6, some Kinds of Diseases.Of Swoonings occasioned by Excess of Blood.§ 495. An excessive Quantity of Blood is frequently a Cause of Swooning; and it may be inferred that it is owing to this Cause, when it attacks sanguine, hearty and robust Persons; and more especially when it attacks them, after being combined with any additional or supervening Cause, that suddenly increased the Motion of theBlood; such as heating Meats or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a long Exposure to the hot Sun, or being detained in a very hot Place; much and violent Exercise; an over intense and assiduous Study or Application, or some excessive Passion.In such Cases, first of all the Patient should be made to smell to, or even to snuff up, some Vinegar; and his Forehead, his Temples and his Wrists should be bathed with it; adding an equal Quantity of warm Water, if at Hand. Bathing them with distilled or spirituous Liquids would be prejudicial in this Kind of Swooning.2, The Patient should be made, if possible, to swallow two or three Spoonfuls of Vinegar, with four or five Times as much Water.3, The Patient's Garters should be tied very tightly above his Knees; as by this Means a greater Quantity of Blood is retained in the Legs, whence the Heart may be less overladen with it.4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into aSyncopè, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him.5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of ElderFlower Tea, with the Addition of a little Sugar and Vinegar.When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention,§ 544, when treating of Persons who superabound with Blood.The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following theDeliquium, or Swooning.Of Swoonings occasioned by Weakness.§ 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much.This Sort of Swooning happens after great Hæmorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in aCholera Morbus(§ 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterateDiarrhœa, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of itsnecessary Sustenance, is attended with the same Consequence as profuse Evacuations.These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them.2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the105EnglishSalt, Spirit of Sal Ammoniac,strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like.3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor,mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready.4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach.5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued.6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine.7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent anyDeliquiumor Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk,&c.§ 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class.Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: andPersons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy.The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter§ 552.Of Faintings occasioned by a Load, or Uneasiness, at Stomach.§ 498. It has been already observed,§ 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate.We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whateverKind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines.A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or ofCarduus Benedictus, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do.The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certainNausea, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady.Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Doseof the Powder,Nº. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions.§ 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient.Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon.Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed withit; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases.This Species of Swooning is oftener attended with a little Feverishness than the others.Of those Swoonings, which arise from nervous Disorders.§ 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them.By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed theVapours; and by the common People, theMother: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easilycomprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach.§ 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by theIrritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one.If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour.Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a wateryDiarrhœa, or Looseness, which frequently proves a very obstinate one.§ 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them.Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service.§ 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it.As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it.Of Swoonings occasioned by the Passions.§ 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment.§ 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel.The calming asswaging Cordial, that has seemedthe most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor ofHoffman,106and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct.It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted.§ 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, aSyncopè.It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the GlystersNº. 5.Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitternessin the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If theNauseaand Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that ofNº. 23, or a few Doses ofNº. 24.Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases.§ 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, andWeakness is an Obstacleto Recovery.In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon asan Evacuation supervenes, whether by Vomit or Stool.When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength.In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it.§ 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, arecured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations.§ 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal.§ 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case.§ 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark theCrisis.Every swooning Fit leaves the Patient in Dejection and Weakness; the Secretions from the Blood are suspended; the Humours disposed to Stagnation; Grumosities, or Coagulations, and Obstructions are formed; and if the Motion of the Blood is totally intercepted, or considerably checked,Polypus's, and these often incurable, are formed in the Heart, or in the larger Vessels; the Consequences of which are dreadful, and sometimes give Rise to internal Aneurisms,which always prove mortal, after long Anxiety and Oppression.Swoonings which attack old People, without any manifest Cause, always afford an unfavourable Prognostic.Of Hæmorrhages, or an involuntary Loss of Blood.§ 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourableCrisis; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life.As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence.A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance—As long as the Pulse is stillpretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse.But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long.§ 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities.2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increasethe Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage.As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once.3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour.4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor ofHoffmanis certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness.The PrescriptionNº. 67, which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must bereduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable.5, When the Flux of Blood is totally stopt, the Patient is to be kept as still and quiet as possible; taking great Care not to extract the Tent which remains in the Nose;norto remove the Clots of coagulated Blood which fill up the Passage. The loosening and removing of these should be effected very gradually and cautiously; and frequently the Tent does not spring out spontaneously, till after many Days.§ 514. I have not, hitherto, said any thing of artificial Bleeding in these Cases, as I think it at best unserviceable; since, though it may sometimes have stopt the morbid Loss of Blood, it has at other times increased it. Neither have I mentioned Anodynes here, whose constant Effect is to determine a larger Quantity of Blood to the Head.Applications of cold Water to the Nape of the Neck ought to be wholly disused, having sometimes been attended with the most embarrassing Consequences.In all Hæmorrhages, all Fluxes of Blood, great Tranquillity, Ligatures, and the Use of the DrinksNº. 2or4, are very useful.§ 515. People who are very liable to frequent Hæmorrhages, ought to manage themselves conformably to the Directions contained in the next Chapter,§ 544. They should take very little Supper; avoid all sharp and spirituous Liquors; Apartments that are over hot, and cover their Heads but very lightly.When a Patient has for a long time been subject to Hæmorrhages, if they cease, he should retrench from his usual Quantity of Food; accustom himself to artificial Bleedings at proper Intervals; and take some gentle opening Purges, especially that ofNº. 24, and frequently a little Nitre in an Evening.Of Convulsion Fits.§ 516. Convulsions are, in general, more terrifying than dangerous; they result from many and various Causes; and on the Removal or Extirpation of these, their Cure depends.In the very Fit itself very little is to be done or attempted.As nothing does shorten the Duration, nor even lessen the Violence, of an epileptic Fit, so nothing at all should be attempted in it; and the rather, because Means and Medicines often aggravate the Disease. We should confine our Endeavours solely to the Security of the Patient, by preventing him from giving himself any violent Strokes; by getting something, if possible, between his Teeth, such as a small Roller of Linen toprevent his Tongue from being hurt, or very dangerously squeezed and bruised, in a strong Convulsion.The only Case which requires immediate Assistance in the Fit, is, when it is so extremely violent, the Neck so swelled, and the Face so very red, that there is Room to be apprehensive of an Apoplexy, which we should endeavour to obviate, by drawing eight or ten Ounces of Blood from the Arm.As this terrible Disease is common in the Country, it is doing a real Service to the unfortunate Victims of it, to inform them how very dangerous it is to give themselves blindly up to take all the Medicines, which are cried up to them in such Cases. If there be any one Disease, which requires a more attentive, delicate, and exquisite Kind of Treatment, it is this very Disease. Some Species of it are wholly incurable: and such as may be susceptible of a Cure, require the utmost Care and Consideration of the most enlightned and most experienced Physicians: while those who pretend to cure all epileptic Patients, with one invariable Medicine, are either Ignorants, or Impostors, and sometimes both in one.§ 517. Simple Convulsion Fits, which are not epileptic, are frequently of a long Continuance, persevering, with very few and short Intervals, for Days and even for Weeks.The true genuine Cause should be investigated as strictly as possible, though nothing should be attempted in the Fit. The Nerves are, duringthat Term, in so high a Degree of Tension and Sensibility, that the very Medicines, supposed to be strongly indicated, often redouble the Storm they were intended to appease.Thin watery Liquors, moderately imbued with Aromatics, are the least hurtful, the most innocent Things that can be given; such as Bawm, Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has sometimes answered better than any other.Of suffocating, or strangling Fits.§ 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours.That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See§ 502.§ 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come onafter any inflaming Cause; when the Pulse is full and strong, and the Countenance red.Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary.2, By the Use of Glysters.3, By drinking plentifully of the PtisanNº. 1; to each Pot of which, a Drachm of Nitre is to be added; and,4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See§ 55.§ 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow.The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion,Nº. 8, if it can be readily had. 2, To make the Patient drink very plentifully of theDrinkNº. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs.If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects.Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little.The MedicineNº. 25, a Dose of which may be taken every two Hours, with a Cup of the PtisanNº. 12, often succeeds very well.But if neither this Medicine, nor the Prescription ofNº. 8are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour.Of the violent Effects of Fear.§ 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy.The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or ragingDeliriumhappen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to.When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence.§ 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves.The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it.They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops ofSydenham'sLiquid Laudanum,Nº. 44; but should that not be near at Hand, a small Dose ofVeniceTreacle.§ 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have justgiven must then be observed, for some successive Evenings, before they are put to Bed.Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return.By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal.If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm.These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise.All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice.107Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine.§ 524. Not a single Year passes over here, without the Destruction of many People by theVapour of Charcoal, or of small Coal, and by the Steam or Vapour of Wine.The Symptoms by Coal occur, when108small Coal, and especially when109Charcoal is burnt in a Chamber close shut, which is direct Poison to a Person shut up in it. The sulphureous Oil, which is set at Liberty and diffused by the Action of Fire, expands itself through the Chamber; while those who are in it perceive a Disorder and Confusion in their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and very unusual Kind of Numbness; become raving, convulsed and trembling; and if they fail of Presence of Mind, or of Strength, to get out of the Chamber, they die within a short Time.I have seen a Woman who had vertiginous Commotions in her Head for two Days, and almost continual Vomitings, from her having been confined less than six Minutes in a Chamber (and that notwithstanding, both one Window and one Door were open) in which there was a Chafing-dish with some burning Coals. Had the Room been quite close, she must have perished by it.This Vapour is narcotic or stupefying, and proves mortal in Consequence of its producing asleepy or apoplectic Disorder, though blended, at the same time, with something convulsive; which sufficiently appears from the Closure of the Mouth, and the strict Contraction or Locking of the Jaws.The Condition of the Brain, in the dissected Bodies of Persons thus destroyed, proves that they die of an Apoplexy: notwithstanding it is very probable that Suffocation is also partly the Cause of their Deaths; as the Lungs have been found stuffed up with Blood and livid.It has also been observed in some other such Bodies, that Patients killed by the Vapour of burning Coals, have commonly their whole Body swelled out to one third more than their Magnitude, when living. The Face, Neck, and Arms are swelled out, as if they had been blown up; and the whole human Machine appears in such a State, as the dead Body of a Person would, who had been violently strangled; and who had made all possible Resistance for a long time, before he was overpowered.§ 525. Such as are sensible of the great Danger they are in, and retreat seasonably from it, are generally relieved as soon as they get into the open Air; or if they have any remaining Uneasiness, a little Water and Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when they are so far poisoned, as to have lost their Feeling and Understanding, if there be any Means of reviving them, such Means consist,1, In exposing them to a very pure, fresh and open Air.2, In making them smell to some very penetrating Odour, which is somewhat stimulating and reviving, such as the volatile Spirit of Sal Ammoniac, the110EnglishSalt; and afterwards to surround them, as it were, with the Steam of Vinegar.3, In taking some Blood from their Arm.4, In putting their Legs into warm or hot Water, and chafing them well.5, In making them swallow, if practicable, much Lemonade, or Water and Vinegar, with the Addition of Nitre: and,6, In throwing up some sharp Glysters.As it is manifest there is something spasmodic in these Cases, it were proper to be provided with some antispasmodic Remedies, such as the Mineral Anodyne Liquid ofHoffman. Even Opium has sometimes been successfully given here, but it should be allowed to Physicians only to direct it in such Cases.A Vomit would be hurtful; and the Reachings to vomit arise only from the Oppression on the Brain.It is a common but erroneous Opinion, that if the Coal be suffered to burn for a Minute or so in the open Air, or in a Chimney, it is sufficient to prevent any Danger from the Vapour of it.Hence it amounts even to a criminal Degree of Imprudence, to sleep in a Chamber whileCharcoal or small Coal is burning in it; and the Number of such imprudent Persons, as have never awaked after it, is so considerable, and so generally known too, that the Continuance of this unhappy Custom is astonishing.§ 526. The Bakers, who make Use of much small Coal, often keep great Quantities of it in their Cellars, which frequently abound so much with the Vapour of it, that it seizes them violently the Moment they enter into the Cellar. They sink down at once deprived of all Sensation, and die if they are not drawn out of it soon enough to be assisted, according to the Directions I have just given.One certain Means of preventing such fatal Accidents is, upon going into the Cellar to throw some flaming Paper or Straw into it, and if these continue to flame out and consume, there is no Reason for dreading the Vapour: but if they should be extinguished, no Person should venture in. But after opening the Vent-hole, a Bundle of flaming Straw must be set at the Door, which serves to attract the external Air strongly. Soon after the Experiment of the flaming Paper must be repeated, and if it goes out, more Straw is to be set on Fire before the Cellar Door.§ 527. Small Coal, burnt in an open Fire, is not near so dangerous asCharcoal, properly so called, the Danger of which arises from this, that in extinguishing it by the usual Methods, all those sulphureous Particles of it, in which its Danger consists, are concentred. Nevertheless, smallCoal is not entirely deprived of all its noxious Quality, without some of which it could not strictly be Coal.The common Method of throwing some Salt on live Coals, before they are conveyed into a Chamber; or of casting a Piece of Iron among them to imbibe some Part of their deadly narcotic Sulphur, is not without its Utility; though by no means sufficient to prevent all Danger from them.§ 528. When the most dangerous Symptoms from this Cause disappear, and there remains only some Degree of Weakness, of Numbness, and a little Inappetency, or Loathing at Stomach, nothing is better than Lemonade with one fourth Part Wine, half a Cup of which should frequently be taken, with a small Crust of Bread.§ 529. The Vapour which exhales from Wine, and in general from all fermenting Liquors, such as Beer, Cyder,&c.contains something poisonous, which kills in the like Manner with the Vapour of Coal; and there is always some Danger in going into a Cellar, where there is much Wine in the State of Fermentation; if it has been shut up close for several Hours. There have been many Examples of Persons struck dead on entering one, and of others who have escaped out of it with Difficulty.When such unhappy Accidents occur, Men should not be successively exposed, one after another, to perish, by endeavouring to fetch out the first who sunk down upon his Entrance; butthe Air should immediately be purified by the Method already directed, or by discharging some Guns into the Cellar; after which People may venture in with Precaution. And when the Persons unfortunately affected are brought out, they are to be treated like those, who were affected with the Coal-Vapour.I saw a Man, about eight Years since, who was not sensible of the Application of Spirit of Sal Ammoniac, till about an Hour after he was struck down, and who was entirely freed at last by a plentiful Bleeding; though he had been so insensible, that it was several Hours before he discovered a very great Wound he had, which extended from the Middle of his Arm to his Armpit, and which was made by a Hook intended to be used, in Case of a House catching Fire, to assist Persons in escaping from the Flames.§ 530. When subterraneous Caves that have been very long shut are opened; or when deep Wells are cleaned, that have not been emptied for several Years, the Vapours arising from them produce the same Symptoms I have mentioned, and require the same Assistance. They are to be cleansed and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as compounded of both.§ 531. The offensive Stink of Lamps and of Candles, especially when their Flames are extinguished, operate like other Vapours, though with less Violence, and less suddenly.Neverthelessthere have been Instances of Peoplekilled by the Fumes of Lamps fed with Nut Oil, which had been extinguished in a close Room. These last Smells or Fumes prove noxious also, in Consequence of their Greasiness, which being conveyed, together with the Air, into the Lungs, prevent their Respiration: And hence we may observe, that Persons of weak delicate Breasts find themselves quickly oppressed in Chambers or Apartments, illuminated with many Candles.The proper Remedies have been already directed,§ 525. The Steam of Vinegar is very serviceable in such Cases.Of Poisons.§ 532. There are a great Number of Poisons, whose Manner of acting is not alike; and whose ill Effects are to be opposed by different Remedies: But Arsenic, or Ratsbane, and some particular Plants are the Poisons which are the most frequently productive of Mischief, in Country Places.§ 533. It is in Consequence of its excessive Acrimony, or violent Heat and Sharpness, which corrodes or gnaws, that Arsenic destroys by an excessive Inflammation, with a burning Fire as it were, most torturing Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody Vomitings, and Stools, Convulsions, Faintings,&c.The best Remedy of all is pouring down whole Torrents of Milk, or, where there is not Milk, of warm Water. Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable.As soon as ever the tormenting Pains are felt in the Belly, and the Intestines seem attacked, Glysters of Milk must be very frequently thrown up.If at the very Beginning of the Attack, the Patient has a strong Pulse, a very large Bleeding may be considerably serviceable by its delaying the Progress, and diminishing the Degree of Inflammation.And even though it should happen that a Patient overcomes the first Violence of this dreadful Accident, it is too common for him to continue in a languid State for a long Time, and sometimes for all the Remainder of his Life. The most certain Method of preventing this Misery, is to live for some Months solely upon Milk,and some very new laid Eggs, just received from the Hen, and dissolved or blended in the Milk, without boiling them.§ 534. The Plants which chiefly produce these unhappy Accidents are some Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of theBella Donna, or deadly Nightshade, which Children eat by mistake for Cherries; some Kind of Mushrooms, the Seed of theDatura, or the stinking Thorn-Apple.All the Poisons of this Class prove mortal rather from a narcotic, or stupefying, than from an acrid, or very sharp Quality. Vertigos, Faintings, Reachings to vomit, and actual Vomitings are the first Symptoms produced by them.The Patient should immediately swallow down a large Quantity of Water, moderately seasoned with Salt or with Sugar; and then a Vomiting should be excited as soon as possible by the PrescriptionNº. 34or35: or, if neither of these is very readily procurable, with Radish-seed pounded, to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon after forcing a Feather or a Finger into the Patient's Throat, to expedite the Vomiting.After the Operation of the Vomit, he must continue to take a large Quantity of Water, sweetened with Honey or Sugar, together with a considerable Quantity of Vinegar, which is the true Specific, or Antidote, as it were, against those Poisons: the Intestines must also be emptied by a few Glysters.Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the Roots of theOenanthè; or Water-hemlock, became all extremely sick; when the Emetic,Nº. 34, with the Assistance of Glysters, and very plentiful drinking of warm Water, saved all but one of them, who died before he could be assisted.§ 535. If a Person has taken too much Opium; or any Medicine into which it enters, asVeniceTreacle, Mithridate, Diascordium,&c.whether by Imprudence, Mistake, Ignorance, or through any bad Design, he must be bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See§ 147) by Reason that Opium in Effect produces such a one. He should snuff up and inhale the Vapour of Vinegar plentifully, adding it also liberally to the Water he is to drink.Of acute Pains.§ 536. It is not my Intention to treat here of those Pains, that accompany any evident known Disease, and which should be conducted as relating to such Diseases; nor of such Pains as infirm valetudinary Persons are habitually subject to; since Experience has informed such of the most effectual Relief for them: But when a Person sound and hale, finds himself suddenly attacked with some excessive Pain, in whatever Part it occurs, without knowing either the Nature, orthe Cause of it, they may, till proper Advice can be procured,1, Part with some Blood, which, by abating the Fulness and Tension, almost constantly asswages the Pains, at least for some Time: and it may even be repeated, if, without weakening the Patient much, it has lessened the Violence of the Pain.2, The Patient should drink abundantly of some very mild temperate Drink, such as the PtisanNº. 2, the Almond EmulsionNº. 4, or warm Water with a fourth or fifth Part Milk.3, Several emollient Glysters should be given.4, The whole Part that is affected, and the adjoining Parts should be covered with Cataplasms, or soothed with the emollient Fomentation,Nº. 9.5, The warm Bath may also be advantagiously used.6, If notwithstanding all these Assistances, the Pain should still continue violent, and the Pulse is neither full nor hard, the grown Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of liquid Laudanum; and when neither of these are to be had,111anEnglishPint of boiling Water must be poured upon three or four Poppy-heads with their Seeds, but without the Leaves, and this Decoction is to be drank like Tea.§ 537. Persons very subject to frequent Pains, and especially to violent Head-achs, should abstainfrom all strong Drink; such Abstinence being often the only Means of curing them: And People are very often mistaken in supposing Wine necessary for as many as seem to have a weak Stomach.

Chapter XXXI.Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains.Of Swoonings.Sect.494.There are many Degrees of Swooning, or fainting away: the slightest is that in which the Patient constantly perceives and understands, yet without the Power of speaking. This is called a Fainting, which happens very often to vapourishPersons, and without any remarkable Alteration of the Pulse.If the Patient entirely loses Sensation, or Feeling, and Understanding, with a very considerable Sinking of the Pulse, this is called aSyncopè, and is the second Degree of Swooning.But if thisSyncopèis so violent, that the Pulse seems totally extinguished; without any discernible Breathing; with a manifest Coldness of the whole Body; and a wanly livid Countenance, it constitutes a third and last Degree, which is the true Image of Death, that in Effect sometimes attends it, and it is called anAsphixy, which may signify a total Resolution.Swoonings result from many different Causes, of which I shall only enumerate the principal; and these are, 1, Too large a Quantity of Blood. 2, A Defect or insufficient Proportion of it, and a general Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous Maladies. 5, The Passions; and, 6, some Kinds of Diseases.Of Swoonings occasioned by Excess of Blood.§ 495. An excessive Quantity of Blood is frequently a Cause of Swooning; and it may be inferred that it is owing to this Cause, when it attacks sanguine, hearty and robust Persons; and more especially when it attacks them, after being combined with any additional or supervening Cause, that suddenly increased the Motion of theBlood; such as heating Meats or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a long Exposure to the hot Sun, or being detained in a very hot Place; much and violent Exercise; an over intense and assiduous Study or Application, or some excessive Passion.In such Cases, first of all the Patient should be made to smell to, or even to snuff up, some Vinegar; and his Forehead, his Temples and his Wrists should be bathed with it; adding an equal Quantity of warm Water, if at Hand. Bathing them with distilled or spirituous Liquids would be prejudicial in this Kind of Swooning.2, The Patient should be made, if possible, to swallow two or three Spoonfuls of Vinegar, with four or five Times as much Water.3, The Patient's Garters should be tied very tightly above his Knees; as by this Means a greater Quantity of Blood is retained in the Legs, whence the Heart may be less overladen with it.4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into aSyncopè, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him.5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of ElderFlower Tea, with the Addition of a little Sugar and Vinegar.When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention,§ 544, when treating of Persons who superabound with Blood.The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following theDeliquium, or Swooning.Of Swoonings occasioned by Weakness.§ 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much.This Sort of Swooning happens after great Hæmorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in aCholera Morbus(§ 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterateDiarrhœa, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of itsnecessary Sustenance, is attended with the same Consequence as profuse Evacuations.These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them.2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the105EnglishSalt, Spirit of Sal Ammoniac,strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like.3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor,mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready.4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach.5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued.6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine.7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent anyDeliquiumor Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk,&c.§ 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class.Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: andPersons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy.The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter§ 552.Of Faintings occasioned by a Load, or Uneasiness, at Stomach.§ 498. It has been already observed,§ 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate.We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whateverKind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines.A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or ofCarduus Benedictus, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do.The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certainNausea, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady.Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Doseof the Powder,Nº. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions.§ 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient.Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon.Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed withit; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases.This Species of Swooning is oftener attended with a little Feverishness than the others.Of those Swoonings, which arise from nervous Disorders.§ 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them.By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed theVapours; and by the common People, theMother: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easilycomprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach.§ 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by theIrritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one.If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour.Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a wateryDiarrhœa, or Looseness, which frequently proves a very obstinate one.§ 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them.Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service.§ 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it.As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it.Of Swoonings occasioned by the Passions.§ 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment.§ 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel.The calming asswaging Cordial, that has seemedthe most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor ofHoffman,106and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct.It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted.§ 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, aSyncopè.It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the GlystersNº. 5.Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitternessin the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If theNauseaand Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that ofNº. 23, or a few Doses ofNº. 24.Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases.§ 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, andWeakness is an Obstacleto Recovery.In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon asan Evacuation supervenes, whether by Vomit or Stool.When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength.In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it.§ 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, arecured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations.§ 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal.§ 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case.§ 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark theCrisis.Every swooning Fit leaves the Patient in Dejection and Weakness; the Secretions from the Blood are suspended; the Humours disposed to Stagnation; Grumosities, or Coagulations, and Obstructions are formed; and if the Motion of the Blood is totally intercepted, or considerably checked,Polypus's, and these often incurable, are formed in the Heart, or in the larger Vessels; the Consequences of which are dreadful, and sometimes give Rise to internal Aneurisms,which always prove mortal, after long Anxiety and Oppression.Swoonings which attack old People, without any manifest Cause, always afford an unfavourable Prognostic.Of Hæmorrhages, or an involuntary Loss of Blood.§ 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourableCrisis; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life.As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence.A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance—As long as the Pulse is stillpretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse.But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long.§ 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities.2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increasethe Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage.As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once.3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour.4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor ofHoffmanis certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness.The PrescriptionNº. 67, which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must bereduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable.5, When the Flux of Blood is totally stopt, the Patient is to be kept as still and quiet as possible; taking great Care not to extract the Tent which remains in the Nose;norto remove the Clots of coagulated Blood which fill up the Passage. The loosening and removing of these should be effected very gradually and cautiously; and frequently the Tent does not spring out spontaneously, till after many Days.§ 514. I have not, hitherto, said any thing of artificial Bleeding in these Cases, as I think it at best unserviceable; since, though it may sometimes have stopt the morbid Loss of Blood, it has at other times increased it. Neither have I mentioned Anodynes here, whose constant Effect is to determine a larger Quantity of Blood to the Head.Applications of cold Water to the Nape of the Neck ought to be wholly disused, having sometimes been attended with the most embarrassing Consequences.In all Hæmorrhages, all Fluxes of Blood, great Tranquillity, Ligatures, and the Use of the DrinksNº. 2or4, are very useful.§ 515. People who are very liable to frequent Hæmorrhages, ought to manage themselves conformably to the Directions contained in the next Chapter,§ 544. They should take very little Supper; avoid all sharp and spirituous Liquors; Apartments that are over hot, and cover their Heads but very lightly.When a Patient has for a long time been subject to Hæmorrhages, if they cease, he should retrench from his usual Quantity of Food; accustom himself to artificial Bleedings at proper Intervals; and take some gentle opening Purges, especially that ofNº. 24, and frequently a little Nitre in an Evening.Of Convulsion Fits.§ 516. Convulsions are, in general, more terrifying than dangerous; they result from many and various Causes; and on the Removal or Extirpation of these, their Cure depends.In the very Fit itself very little is to be done or attempted.As nothing does shorten the Duration, nor even lessen the Violence, of an epileptic Fit, so nothing at all should be attempted in it; and the rather, because Means and Medicines often aggravate the Disease. We should confine our Endeavours solely to the Security of the Patient, by preventing him from giving himself any violent Strokes; by getting something, if possible, between his Teeth, such as a small Roller of Linen toprevent his Tongue from being hurt, or very dangerously squeezed and bruised, in a strong Convulsion.The only Case which requires immediate Assistance in the Fit, is, when it is so extremely violent, the Neck so swelled, and the Face so very red, that there is Room to be apprehensive of an Apoplexy, which we should endeavour to obviate, by drawing eight or ten Ounces of Blood from the Arm.As this terrible Disease is common in the Country, it is doing a real Service to the unfortunate Victims of it, to inform them how very dangerous it is to give themselves blindly up to take all the Medicines, which are cried up to them in such Cases. If there be any one Disease, which requires a more attentive, delicate, and exquisite Kind of Treatment, it is this very Disease. Some Species of it are wholly incurable: and such as may be susceptible of a Cure, require the utmost Care and Consideration of the most enlightned and most experienced Physicians: while those who pretend to cure all epileptic Patients, with one invariable Medicine, are either Ignorants, or Impostors, and sometimes both in one.§ 517. Simple Convulsion Fits, which are not epileptic, are frequently of a long Continuance, persevering, with very few and short Intervals, for Days and even for Weeks.The true genuine Cause should be investigated as strictly as possible, though nothing should be attempted in the Fit. The Nerves are, duringthat Term, in so high a Degree of Tension and Sensibility, that the very Medicines, supposed to be strongly indicated, often redouble the Storm they were intended to appease.Thin watery Liquors, moderately imbued with Aromatics, are the least hurtful, the most innocent Things that can be given; such as Bawm, Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has sometimes answered better than any other.Of suffocating, or strangling Fits.§ 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours.That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See§ 502.§ 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come onafter any inflaming Cause; when the Pulse is full and strong, and the Countenance red.Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary.2, By the Use of Glysters.3, By drinking plentifully of the PtisanNº. 1; to each Pot of which, a Drachm of Nitre is to be added; and,4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See§ 55.§ 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow.The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion,Nº. 8, if it can be readily had. 2, To make the Patient drink very plentifully of theDrinkNº. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs.If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects.Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little.The MedicineNº. 25, a Dose of which may be taken every two Hours, with a Cup of the PtisanNº. 12, often succeeds very well.But if neither this Medicine, nor the Prescription ofNº. 8are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour.Of the violent Effects of Fear.§ 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy.The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or ragingDeliriumhappen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to.When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence.§ 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves.The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it.They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops ofSydenham'sLiquid Laudanum,Nº. 44; but should that not be near at Hand, a small Dose ofVeniceTreacle.§ 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have justgiven must then be observed, for some successive Evenings, before they are put to Bed.Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return.By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal.If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm.These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise.All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice.107Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine.§ 524. Not a single Year passes over here, without the Destruction of many People by theVapour of Charcoal, or of small Coal, and by the Steam or Vapour of Wine.The Symptoms by Coal occur, when108small Coal, and especially when109Charcoal is burnt in a Chamber close shut, which is direct Poison to a Person shut up in it. The sulphureous Oil, which is set at Liberty and diffused by the Action of Fire, expands itself through the Chamber; while those who are in it perceive a Disorder and Confusion in their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and very unusual Kind of Numbness; become raving, convulsed and trembling; and if they fail of Presence of Mind, or of Strength, to get out of the Chamber, they die within a short Time.I have seen a Woman who had vertiginous Commotions in her Head for two Days, and almost continual Vomitings, from her having been confined less than six Minutes in a Chamber (and that notwithstanding, both one Window and one Door were open) in which there was a Chafing-dish with some burning Coals. Had the Room been quite close, she must have perished by it.This Vapour is narcotic or stupefying, and proves mortal in Consequence of its producing asleepy or apoplectic Disorder, though blended, at the same time, with something convulsive; which sufficiently appears from the Closure of the Mouth, and the strict Contraction or Locking of the Jaws.The Condition of the Brain, in the dissected Bodies of Persons thus destroyed, proves that they die of an Apoplexy: notwithstanding it is very probable that Suffocation is also partly the Cause of their Deaths; as the Lungs have been found stuffed up with Blood and livid.It has also been observed in some other such Bodies, that Patients killed by the Vapour of burning Coals, have commonly their whole Body swelled out to one third more than their Magnitude, when living. The Face, Neck, and Arms are swelled out, as if they had been blown up; and the whole human Machine appears in such a State, as the dead Body of a Person would, who had been violently strangled; and who had made all possible Resistance for a long time, before he was overpowered.§ 525. Such as are sensible of the great Danger they are in, and retreat seasonably from it, are generally relieved as soon as they get into the open Air; or if they have any remaining Uneasiness, a little Water and Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when they are so far poisoned, as to have lost their Feeling and Understanding, if there be any Means of reviving them, such Means consist,1, In exposing them to a very pure, fresh and open Air.2, In making them smell to some very penetrating Odour, which is somewhat stimulating and reviving, such as the volatile Spirit of Sal Ammoniac, the110EnglishSalt; and afterwards to surround them, as it were, with the Steam of Vinegar.3, In taking some Blood from their Arm.4, In putting their Legs into warm or hot Water, and chafing them well.5, In making them swallow, if practicable, much Lemonade, or Water and Vinegar, with the Addition of Nitre: and,6, In throwing up some sharp Glysters.As it is manifest there is something spasmodic in these Cases, it were proper to be provided with some antispasmodic Remedies, such as the Mineral Anodyne Liquid ofHoffman. Even Opium has sometimes been successfully given here, but it should be allowed to Physicians only to direct it in such Cases.A Vomit would be hurtful; and the Reachings to vomit arise only from the Oppression on the Brain.It is a common but erroneous Opinion, that if the Coal be suffered to burn for a Minute or so in the open Air, or in a Chimney, it is sufficient to prevent any Danger from the Vapour of it.Hence it amounts even to a criminal Degree of Imprudence, to sleep in a Chamber whileCharcoal or small Coal is burning in it; and the Number of such imprudent Persons, as have never awaked after it, is so considerable, and so generally known too, that the Continuance of this unhappy Custom is astonishing.§ 526. The Bakers, who make Use of much small Coal, often keep great Quantities of it in their Cellars, which frequently abound so much with the Vapour of it, that it seizes them violently the Moment they enter into the Cellar. They sink down at once deprived of all Sensation, and die if they are not drawn out of it soon enough to be assisted, according to the Directions I have just given.One certain Means of preventing such fatal Accidents is, upon going into the Cellar to throw some flaming Paper or Straw into it, and if these continue to flame out and consume, there is no Reason for dreading the Vapour: but if they should be extinguished, no Person should venture in. But after opening the Vent-hole, a Bundle of flaming Straw must be set at the Door, which serves to attract the external Air strongly. Soon after the Experiment of the flaming Paper must be repeated, and if it goes out, more Straw is to be set on Fire before the Cellar Door.§ 527. Small Coal, burnt in an open Fire, is not near so dangerous asCharcoal, properly so called, the Danger of which arises from this, that in extinguishing it by the usual Methods, all those sulphureous Particles of it, in which its Danger consists, are concentred. Nevertheless, smallCoal is not entirely deprived of all its noxious Quality, without some of which it could not strictly be Coal.The common Method of throwing some Salt on live Coals, before they are conveyed into a Chamber; or of casting a Piece of Iron among them to imbibe some Part of their deadly narcotic Sulphur, is not without its Utility; though by no means sufficient to prevent all Danger from them.§ 528. When the most dangerous Symptoms from this Cause disappear, and there remains only some Degree of Weakness, of Numbness, and a little Inappetency, or Loathing at Stomach, nothing is better than Lemonade with one fourth Part Wine, half a Cup of which should frequently be taken, with a small Crust of Bread.§ 529. The Vapour which exhales from Wine, and in general from all fermenting Liquors, such as Beer, Cyder,&c.contains something poisonous, which kills in the like Manner with the Vapour of Coal; and there is always some Danger in going into a Cellar, where there is much Wine in the State of Fermentation; if it has been shut up close for several Hours. There have been many Examples of Persons struck dead on entering one, and of others who have escaped out of it with Difficulty.When such unhappy Accidents occur, Men should not be successively exposed, one after another, to perish, by endeavouring to fetch out the first who sunk down upon his Entrance; butthe Air should immediately be purified by the Method already directed, or by discharging some Guns into the Cellar; after which People may venture in with Precaution. And when the Persons unfortunately affected are brought out, they are to be treated like those, who were affected with the Coal-Vapour.I saw a Man, about eight Years since, who was not sensible of the Application of Spirit of Sal Ammoniac, till about an Hour after he was struck down, and who was entirely freed at last by a plentiful Bleeding; though he had been so insensible, that it was several Hours before he discovered a very great Wound he had, which extended from the Middle of his Arm to his Armpit, and which was made by a Hook intended to be used, in Case of a House catching Fire, to assist Persons in escaping from the Flames.§ 530. When subterraneous Caves that have been very long shut are opened; or when deep Wells are cleaned, that have not been emptied for several Years, the Vapours arising from them produce the same Symptoms I have mentioned, and require the same Assistance. They are to be cleansed and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as compounded of both.§ 531. The offensive Stink of Lamps and of Candles, especially when their Flames are extinguished, operate like other Vapours, though with less Violence, and less suddenly.Neverthelessthere have been Instances of Peoplekilled by the Fumes of Lamps fed with Nut Oil, which had been extinguished in a close Room. These last Smells or Fumes prove noxious also, in Consequence of their Greasiness, which being conveyed, together with the Air, into the Lungs, prevent their Respiration: And hence we may observe, that Persons of weak delicate Breasts find themselves quickly oppressed in Chambers or Apartments, illuminated with many Candles.The proper Remedies have been already directed,§ 525. The Steam of Vinegar is very serviceable in such Cases.Of Poisons.§ 532. There are a great Number of Poisons, whose Manner of acting is not alike; and whose ill Effects are to be opposed by different Remedies: But Arsenic, or Ratsbane, and some particular Plants are the Poisons which are the most frequently productive of Mischief, in Country Places.§ 533. It is in Consequence of its excessive Acrimony, or violent Heat and Sharpness, which corrodes or gnaws, that Arsenic destroys by an excessive Inflammation, with a burning Fire as it were, most torturing Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody Vomitings, and Stools, Convulsions, Faintings,&c.The best Remedy of all is pouring down whole Torrents of Milk, or, where there is not Milk, of warm Water. Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable.As soon as ever the tormenting Pains are felt in the Belly, and the Intestines seem attacked, Glysters of Milk must be very frequently thrown up.If at the very Beginning of the Attack, the Patient has a strong Pulse, a very large Bleeding may be considerably serviceable by its delaying the Progress, and diminishing the Degree of Inflammation.And even though it should happen that a Patient overcomes the first Violence of this dreadful Accident, it is too common for him to continue in a languid State for a long Time, and sometimes for all the Remainder of his Life. The most certain Method of preventing this Misery, is to live for some Months solely upon Milk,and some very new laid Eggs, just received from the Hen, and dissolved or blended in the Milk, without boiling them.§ 534. The Plants which chiefly produce these unhappy Accidents are some Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of theBella Donna, or deadly Nightshade, which Children eat by mistake for Cherries; some Kind of Mushrooms, the Seed of theDatura, or the stinking Thorn-Apple.All the Poisons of this Class prove mortal rather from a narcotic, or stupefying, than from an acrid, or very sharp Quality. Vertigos, Faintings, Reachings to vomit, and actual Vomitings are the first Symptoms produced by them.The Patient should immediately swallow down a large Quantity of Water, moderately seasoned with Salt or with Sugar; and then a Vomiting should be excited as soon as possible by the PrescriptionNº. 34or35: or, if neither of these is very readily procurable, with Radish-seed pounded, to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon after forcing a Feather or a Finger into the Patient's Throat, to expedite the Vomiting.After the Operation of the Vomit, he must continue to take a large Quantity of Water, sweetened with Honey or Sugar, together with a considerable Quantity of Vinegar, which is the true Specific, or Antidote, as it were, against those Poisons: the Intestines must also be emptied by a few Glysters.Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the Roots of theOenanthè; or Water-hemlock, became all extremely sick; when the Emetic,Nº. 34, with the Assistance of Glysters, and very plentiful drinking of warm Water, saved all but one of them, who died before he could be assisted.§ 535. If a Person has taken too much Opium; or any Medicine into which it enters, asVeniceTreacle, Mithridate, Diascordium,&c.whether by Imprudence, Mistake, Ignorance, or through any bad Design, he must be bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See§ 147) by Reason that Opium in Effect produces such a one. He should snuff up and inhale the Vapour of Vinegar plentifully, adding it also liberally to the Water he is to drink.Of acute Pains.§ 536. It is not my Intention to treat here of those Pains, that accompany any evident known Disease, and which should be conducted as relating to such Diseases; nor of such Pains as infirm valetudinary Persons are habitually subject to; since Experience has informed such of the most effectual Relief for them: But when a Person sound and hale, finds himself suddenly attacked with some excessive Pain, in whatever Part it occurs, without knowing either the Nature, orthe Cause of it, they may, till proper Advice can be procured,1, Part with some Blood, which, by abating the Fulness and Tension, almost constantly asswages the Pains, at least for some Time: and it may even be repeated, if, without weakening the Patient much, it has lessened the Violence of the Pain.2, The Patient should drink abundantly of some very mild temperate Drink, such as the PtisanNº. 2, the Almond EmulsionNº. 4, or warm Water with a fourth or fifth Part Milk.3, Several emollient Glysters should be given.4, The whole Part that is affected, and the adjoining Parts should be covered with Cataplasms, or soothed with the emollient Fomentation,Nº. 9.5, The warm Bath may also be advantagiously used.6, If notwithstanding all these Assistances, the Pain should still continue violent, and the Pulse is neither full nor hard, the grown Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of liquid Laudanum; and when neither of these are to be had,111anEnglishPint of boiling Water must be poured upon three or four Poppy-heads with their Seeds, but without the Leaves, and this Decoction is to be drank like Tea.§ 537. Persons very subject to frequent Pains, and especially to violent Head-achs, should abstainfrom all strong Drink; such Abstinence being often the only Means of curing them: And People are very often mistaken in supposing Wine necessary for as many as seem to have a weak Stomach.

Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains.

Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains.

Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains.

Of Swoonings.Sect.494.There are many Degrees of Swooning, or fainting away: the slightest is that in which the Patient constantly perceives and understands, yet without the Power of speaking. This is called a Fainting, which happens very often to vapourishPersons, and without any remarkable Alteration of the Pulse.If the Patient entirely loses Sensation, or Feeling, and Understanding, with a very considerable Sinking of the Pulse, this is called aSyncopè, and is the second Degree of Swooning.But if thisSyncopèis so violent, that the Pulse seems totally extinguished; without any discernible Breathing; with a manifest Coldness of the whole Body; and a wanly livid Countenance, it constitutes a third and last Degree, which is the true Image of Death, that in Effect sometimes attends it, and it is called anAsphixy, which may signify a total Resolution.Swoonings result from many different Causes, of which I shall only enumerate the principal; and these are, 1, Too large a Quantity of Blood. 2, A Defect or insufficient Proportion of it, and a general Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous Maladies. 5, The Passions; and, 6, some Kinds of Diseases.

Sect.494.

Sect.494.

There are many Degrees of Swooning, or fainting away: the slightest is that in which the Patient constantly perceives and understands, yet without the Power of speaking. This is called a Fainting, which happens very often to vapourishPersons, and without any remarkable Alteration of the Pulse.

If the Patient entirely loses Sensation, or Feeling, and Understanding, with a very considerable Sinking of the Pulse, this is called aSyncopè, and is the second Degree of Swooning.

But if thisSyncopèis so violent, that the Pulse seems totally extinguished; without any discernible Breathing; with a manifest Coldness of the whole Body; and a wanly livid Countenance, it constitutes a third and last Degree, which is the true Image of Death, that in Effect sometimes attends it, and it is called anAsphixy, which may signify a total Resolution.

Swoonings result from many different Causes, of which I shall only enumerate the principal; and these are, 1, Too large a Quantity of Blood. 2, A Defect or insufficient Proportion of it, and a general Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous Maladies. 5, The Passions; and, 6, some Kinds of Diseases.

Of Swoonings occasioned by Excess of Blood.§ 495. An excessive Quantity of Blood is frequently a Cause of Swooning; and it may be inferred that it is owing to this Cause, when it attacks sanguine, hearty and robust Persons; and more especially when it attacks them, after being combined with any additional or supervening Cause, that suddenly increased the Motion of theBlood; such as heating Meats or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a long Exposure to the hot Sun, or being detained in a very hot Place; much and violent Exercise; an over intense and assiduous Study or Application, or some excessive Passion.In such Cases, first of all the Patient should be made to smell to, or even to snuff up, some Vinegar; and his Forehead, his Temples and his Wrists should be bathed with it; adding an equal Quantity of warm Water, if at Hand. Bathing them with distilled or spirituous Liquids would be prejudicial in this Kind of Swooning.2, The Patient should be made, if possible, to swallow two or three Spoonfuls of Vinegar, with four or five Times as much Water.3, The Patient's Garters should be tied very tightly above his Knees; as by this Means a greater Quantity of Blood is retained in the Legs, whence the Heart may be less overladen with it.4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into aSyncopè, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him.5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of ElderFlower Tea, with the Addition of a little Sugar and Vinegar.When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention,§ 544, when treating of Persons who superabound with Blood.The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following theDeliquium, or Swooning.

§ 495. An excessive Quantity of Blood is frequently a Cause of Swooning; and it may be inferred that it is owing to this Cause, when it attacks sanguine, hearty and robust Persons; and more especially when it attacks them, after being combined with any additional or supervening Cause, that suddenly increased the Motion of theBlood; such as heating Meats or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a long Exposure to the hot Sun, or being detained in a very hot Place; much and violent Exercise; an over intense and assiduous Study or Application, or some excessive Passion.

In such Cases, first of all the Patient should be made to smell to, or even to snuff up, some Vinegar; and his Forehead, his Temples and his Wrists should be bathed with it; adding an equal Quantity of warm Water, if at Hand. Bathing them with distilled or spirituous Liquids would be prejudicial in this Kind of Swooning.

2, The Patient should be made, if possible, to swallow two or three Spoonfuls of Vinegar, with four or five Times as much Water.

3, The Patient's Garters should be tied very tightly above his Knees; as by this Means a greater Quantity of Blood is retained in the Legs, whence the Heart may be less overladen with it.

4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into aSyncopè, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him.

5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of ElderFlower Tea, with the Addition of a little Sugar and Vinegar.

When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention,§ 544, when treating of Persons who superabound with Blood.

The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following theDeliquium, or Swooning.

Of Swoonings occasioned by Weakness.§ 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much.This Sort of Swooning happens after great Hæmorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in aCholera Morbus(§ 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterateDiarrhœa, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of itsnecessary Sustenance, is attended with the same Consequence as profuse Evacuations.These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them.2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the105EnglishSalt, Spirit of Sal Ammoniac,strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like.3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor,mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready.4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach.5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued.6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine.7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent anyDeliquiumor Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk,&c.§ 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class.Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: andPersons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy.The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter§ 552.

§ 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much.

This Sort of Swooning happens after great Hæmorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in aCholera Morbus(§ 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterateDiarrhœa, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of itsnecessary Sustenance, is attended with the same Consequence as profuse Evacuations.

These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them.

2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the105EnglishSalt, Spirit of Sal Ammoniac,strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like.

3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor,mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready.

4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach.

5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued.

6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine.

7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent anyDeliquiumor Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk,&c.

§ 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class.

Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: andPersons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy.

The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter§ 552.

Of Faintings occasioned by a Load, or Uneasiness, at Stomach.§ 498. It has been already observed,§ 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate.We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whateverKind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines.A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or ofCarduus Benedictus, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do.The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certainNausea, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady.Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Doseof the Powder,Nº. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions.§ 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient.Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon.Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed withit; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases.This Species of Swooning is oftener attended with a little Feverishness than the others.

§ 498. It has been already observed,§ 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate.

We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whateverKind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines.

A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or ofCarduus Benedictus, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do.

The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certainNausea, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady.

Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Doseof the Powder,Nº. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions.

§ 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient.

Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon.

Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed withit; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases.

This Species of Swooning is oftener attended with a little Feverishness than the others.

Of those Swoonings, which arise from nervous Disorders.§ 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them.By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed theVapours; and by the common People, theMother: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easilycomprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach.§ 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by theIrritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one.If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour.Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a wateryDiarrhœa, or Looseness, which frequently proves a very obstinate one.§ 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them.Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service.§ 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it.As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it.

§ 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them.

By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed theVapours; and by the common People, theMother: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easilycomprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach.

§ 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by theIrritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one.

If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour.

Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a wateryDiarrhœa, or Looseness, which frequently proves a very obstinate one.

§ 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them.

Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service.

§ 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it.

As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it.

Of Swoonings occasioned by the Passions.§ 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment.§ 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel.The calming asswaging Cordial, that has seemedthe most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor ofHoffman,106and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct.It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted.§ 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, aSyncopè.It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the GlystersNº. 5.Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitternessin the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If theNauseaand Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that ofNº. 23, or a few Doses ofNº. 24.

§ 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment.

§ 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel.

The calming asswaging Cordial, that has seemedthe most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor ofHoffman,106and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct.

It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted.

§ 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, aSyncopè.

It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the GlystersNº. 5.

Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitternessin the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If theNauseaand Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that ofNº. 23, or a few Doses ofNº. 24.

Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases.§ 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, andWeakness is an Obstacleto Recovery.In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon asan Evacuation supervenes, whether by Vomit or Stool.When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength.In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it.§ 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, arecured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations.§ 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal.§ 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case.§ 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark theCrisis.Every swooning Fit leaves the Patient in Dejection and Weakness; the Secretions from the Blood are suspended; the Humours disposed to Stagnation; Grumosities, or Coagulations, and Obstructions are formed; and if the Motion of the Blood is totally intercepted, or considerably checked,Polypus's, and these often incurable, are formed in the Heart, or in the larger Vessels; the Consequences of which are dreadful, and sometimes give Rise to internal Aneurisms,which always prove mortal, after long Anxiety and Oppression.Swoonings which attack old People, without any manifest Cause, always afford an unfavourable Prognostic.

§ 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, andWeakness is an Obstacleto Recovery.

In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon asan Evacuation supervenes, whether by Vomit or Stool.

When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength.

In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it.

§ 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, arecured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations.

§ 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal.

§ 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case.

§ 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark theCrisis.

Every swooning Fit leaves the Patient in Dejection and Weakness; the Secretions from the Blood are suspended; the Humours disposed to Stagnation; Grumosities, or Coagulations, and Obstructions are formed; and if the Motion of the Blood is totally intercepted, or considerably checked,Polypus's, and these often incurable, are formed in the Heart, or in the larger Vessels; the Consequences of which are dreadful, and sometimes give Rise to internal Aneurisms,which always prove mortal, after long Anxiety and Oppression.

Swoonings which attack old People, without any manifest Cause, always afford an unfavourable Prognostic.

Of Hæmorrhages, or an involuntary Loss of Blood.§ 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourableCrisis; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life.As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence.A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance—As long as the Pulse is stillpretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse.But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long.§ 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities.2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increasethe Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage.As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once.3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour.4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor ofHoffmanis certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness.The PrescriptionNº. 67, which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must bereduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable.5, When the Flux of Blood is totally stopt, the Patient is to be kept as still and quiet as possible; taking great Care not to extract the Tent which remains in the Nose;norto remove the Clots of coagulated Blood which fill up the Passage. The loosening and removing of these should be effected very gradually and cautiously; and frequently the Tent does not spring out spontaneously, till after many Days.§ 514. I have not, hitherto, said any thing of artificial Bleeding in these Cases, as I think it at best unserviceable; since, though it may sometimes have stopt the morbid Loss of Blood, it has at other times increased it. Neither have I mentioned Anodynes here, whose constant Effect is to determine a larger Quantity of Blood to the Head.Applications of cold Water to the Nape of the Neck ought to be wholly disused, having sometimes been attended with the most embarrassing Consequences.In all Hæmorrhages, all Fluxes of Blood, great Tranquillity, Ligatures, and the Use of the DrinksNº. 2or4, are very useful.§ 515. People who are very liable to frequent Hæmorrhages, ought to manage themselves conformably to the Directions contained in the next Chapter,§ 544. They should take very little Supper; avoid all sharp and spirituous Liquors; Apartments that are over hot, and cover their Heads but very lightly.When a Patient has for a long time been subject to Hæmorrhages, if they cease, he should retrench from his usual Quantity of Food; accustom himself to artificial Bleedings at proper Intervals; and take some gentle opening Purges, especially that ofNº. 24, and frequently a little Nitre in an Evening.

§ 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourableCrisis; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life.

As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence.

A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance—As long as the Pulse is stillpretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse.

But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long.

§ 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities.

2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increasethe Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage.

As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once.

3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour.

4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor ofHoffmanis certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness.

The PrescriptionNº. 67, which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must bereduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable.

5, When the Flux of Blood is totally stopt, the Patient is to be kept as still and quiet as possible; taking great Care not to extract the Tent which remains in the Nose;norto remove the Clots of coagulated Blood which fill up the Passage. The loosening and removing of these should be effected very gradually and cautiously; and frequently the Tent does not spring out spontaneously, till after many Days.

§ 514. I have not, hitherto, said any thing of artificial Bleeding in these Cases, as I think it at best unserviceable; since, though it may sometimes have stopt the morbid Loss of Blood, it has at other times increased it. Neither have I mentioned Anodynes here, whose constant Effect is to determine a larger Quantity of Blood to the Head.

Applications of cold Water to the Nape of the Neck ought to be wholly disused, having sometimes been attended with the most embarrassing Consequences.

In all Hæmorrhages, all Fluxes of Blood, great Tranquillity, Ligatures, and the Use of the DrinksNº. 2or4, are very useful.

§ 515. People who are very liable to frequent Hæmorrhages, ought to manage themselves conformably to the Directions contained in the next Chapter,§ 544. They should take very little Supper; avoid all sharp and spirituous Liquors; Apartments that are over hot, and cover their Heads but very lightly.

When a Patient has for a long time been subject to Hæmorrhages, if they cease, he should retrench from his usual Quantity of Food; accustom himself to artificial Bleedings at proper Intervals; and take some gentle opening Purges, especially that ofNº. 24, and frequently a little Nitre in an Evening.

Of Convulsion Fits.§ 516. Convulsions are, in general, more terrifying than dangerous; they result from many and various Causes; and on the Removal or Extirpation of these, their Cure depends.In the very Fit itself very little is to be done or attempted.As nothing does shorten the Duration, nor even lessen the Violence, of an epileptic Fit, so nothing at all should be attempted in it; and the rather, because Means and Medicines often aggravate the Disease. We should confine our Endeavours solely to the Security of the Patient, by preventing him from giving himself any violent Strokes; by getting something, if possible, between his Teeth, such as a small Roller of Linen toprevent his Tongue from being hurt, or very dangerously squeezed and bruised, in a strong Convulsion.The only Case which requires immediate Assistance in the Fit, is, when it is so extremely violent, the Neck so swelled, and the Face so very red, that there is Room to be apprehensive of an Apoplexy, which we should endeavour to obviate, by drawing eight or ten Ounces of Blood from the Arm.As this terrible Disease is common in the Country, it is doing a real Service to the unfortunate Victims of it, to inform them how very dangerous it is to give themselves blindly up to take all the Medicines, which are cried up to them in such Cases. If there be any one Disease, which requires a more attentive, delicate, and exquisite Kind of Treatment, it is this very Disease. Some Species of it are wholly incurable: and such as may be susceptible of a Cure, require the utmost Care and Consideration of the most enlightned and most experienced Physicians: while those who pretend to cure all epileptic Patients, with one invariable Medicine, are either Ignorants, or Impostors, and sometimes both in one.§ 517. Simple Convulsion Fits, which are not epileptic, are frequently of a long Continuance, persevering, with very few and short Intervals, for Days and even for Weeks.The true genuine Cause should be investigated as strictly as possible, though nothing should be attempted in the Fit. The Nerves are, duringthat Term, in so high a Degree of Tension and Sensibility, that the very Medicines, supposed to be strongly indicated, often redouble the Storm they were intended to appease.Thin watery Liquors, moderately imbued with Aromatics, are the least hurtful, the most innocent Things that can be given; such as Bawm, Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has sometimes answered better than any other.

§ 516. Convulsions are, in general, more terrifying than dangerous; they result from many and various Causes; and on the Removal or Extirpation of these, their Cure depends.

In the very Fit itself very little is to be done or attempted.

As nothing does shorten the Duration, nor even lessen the Violence, of an epileptic Fit, so nothing at all should be attempted in it; and the rather, because Means and Medicines often aggravate the Disease. We should confine our Endeavours solely to the Security of the Patient, by preventing him from giving himself any violent Strokes; by getting something, if possible, between his Teeth, such as a small Roller of Linen toprevent his Tongue from being hurt, or very dangerously squeezed and bruised, in a strong Convulsion.

The only Case which requires immediate Assistance in the Fit, is, when it is so extremely violent, the Neck so swelled, and the Face so very red, that there is Room to be apprehensive of an Apoplexy, which we should endeavour to obviate, by drawing eight or ten Ounces of Blood from the Arm.

As this terrible Disease is common in the Country, it is doing a real Service to the unfortunate Victims of it, to inform them how very dangerous it is to give themselves blindly up to take all the Medicines, which are cried up to them in such Cases. If there be any one Disease, which requires a more attentive, delicate, and exquisite Kind of Treatment, it is this very Disease. Some Species of it are wholly incurable: and such as may be susceptible of a Cure, require the utmost Care and Consideration of the most enlightned and most experienced Physicians: while those who pretend to cure all epileptic Patients, with one invariable Medicine, are either Ignorants, or Impostors, and sometimes both in one.

§ 517. Simple Convulsion Fits, which are not epileptic, are frequently of a long Continuance, persevering, with very few and short Intervals, for Days and even for Weeks.

The true genuine Cause should be investigated as strictly as possible, though nothing should be attempted in the Fit. The Nerves are, duringthat Term, in so high a Degree of Tension and Sensibility, that the very Medicines, supposed to be strongly indicated, often redouble the Storm they were intended to appease.

Thin watery Liquors, moderately imbued with Aromatics, are the least hurtful, the most innocent Things that can be given; such as Bawm, Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has sometimes answered better than any other.

Of suffocating, or strangling Fits.§ 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours.That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See§ 502.§ 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come onafter any inflaming Cause; when the Pulse is full and strong, and the Countenance red.Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary.2, By the Use of Glysters.3, By drinking plentifully of the PtisanNº. 1; to each Pot of which, a Drachm of Nitre is to be added; and,4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See§ 55.§ 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow.The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion,Nº. 8, if it can be readily had. 2, To make the Patient drink very plentifully of theDrinkNº. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs.If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects.Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little.The MedicineNº. 25, a Dose of which may be taken every two Hours, with a Cup of the PtisanNº. 12, often succeeds very well.But if neither this Medicine, nor the Prescription ofNº. 8are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour.

§ 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours.

That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See§ 502.

§ 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come onafter any inflaming Cause; when the Pulse is full and strong, and the Countenance red.

Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary.

2, By the Use of Glysters.

3, By drinking plentifully of the PtisanNº. 1; to each Pot of which, a Drachm of Nitre is to be added; and,

4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See§ 55.

§ 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow.

The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion,Nº. 8, if it can be readily had. 2, To make the Patient drink very plentifully of theDrinkNº. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs.

If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects.

Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little.

The MedicineNº. 25, a Dose of which may be taken every two Hours, with a Cup of the PtisanNº. 12, often succeeds very well.

But if neither this Medicine, nor the Prescription ofNº. 8are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour.

Of the violent Effects of Fear.§ 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy.The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or ragingDeliriumhappen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to.When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence.§ 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves.The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it.They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops ofSydenham'sLiquid Laudanum,Nº. 44; but should that not be near at Hand, a small Dose ofVeniceTreacle.§ 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have justgiven must then be observed, for some successive Evenings, before they are put to Bed.Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return.By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal.If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm.These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise.All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice.107

§ 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy.

The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or ragingDeliriumhappen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to.

When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence.

§ 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves.

The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it.

They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops ofSydenham'sLiquid Laudanum,Nº. 44; but should that not be near at Hand, a small Dose ofVeniceTreacle.

§ 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have justgiven must then be observed, for some successive Evenings, before they are put to Bed.

Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return.

By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal.

If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm.

These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise.

All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice.107

Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine.§ 524. Not a single Year passes over here, without the Destruction of many People by theVapour of Charcoal, or of small Coal, and by the Steam or Vapour of Wine.The Symptoms by Coal occur, when108small Coal, and especially when109Charcoal is burnt in a Chamber close shut, which is direct Poison to a Person shut up in it. The sulphureous Oil, which is set at Liberty and diffused by the Action of Fire, expands itself through the Chamber; while those who are in it perceive a Disorder and Confusion in their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and very unusual Kind of Numbness; become raving, convulsed and trembling; and if they fail of Presence of Mind, or of Strength, to get out of the Chamber, they die within a short Time.I have seen a Woman who had vertiginous Commotions in her Head for two Days, and almost continual Vomitings, from her having been confined less than six Minutes in a Chamber (and that notwithstanding, both one Window and one Door were open) in which there was a Chafing-dish with some burning Coals. Had the Room been quite close, she must have perished by it.This Vapour is narcotic or stupefying, and proves mortal in Consequence of its producing asleepy or apoplectic Disorder, though blended, at the same time, with something convulsive; which sufficiently appears from the Closure of the Mouth, and the strict Contraction or Locking of the Jaws.The Condition of the Brain, in the dissected Bodies of Persons thus destroyed, proves that they die of an Apoplexy: notwithstanding it is very probable that Suffocation is also partly the Cause of their Deaths; as the Lungs have been found stuffed up with Blood and livid.It has also been observed in some other such Bodies, that Patients killed by the Vapour of burning Coals, have commonly their whole Body swelled out to one third more than their Magnitude, when living. The Face, Neck, and Arms are swelled out, as if they had been blown up; and the whole human Machine appears in such a State, as the dead Body of a Person would, who had been violently strangled; and who had made all possible Resistance for a long time, before he was overpowered.§ 525. Such as are sensible of the great Danger they are in, and retreat seasonably from it, are generally relieved as soon as they get into the open Air; or if they have any remaining Uneasiness, a little Water and Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when they are so far poisoned, as to have lost their Feeling and Understanding, if there be any Means of reviving them, such Means consist,1, In exposing them to a very pure, fresh and open Air.2, In making them smell to some very penetrating Odour, which is somewhat stimulating and reviving, such as the volatile Spirit of Sal Ammoniac, the110EnglishSalt; and afterwards to surround them, as it were, with the Steam of Vinegar.3, In taking some Blood from their Arm.4, In putting their Legs into warm or hot Water, and chafing them well.5, In making them swallow, if practicable, much Lemonade, or Water and Vinegar, with the Addition of Nitre: and,6, In throwing up some sharp Glysters.As it is manifest there is something spasmodic in these Cases, it were proper to be provided with some antispasmodic Remedies, such as the Mineral Anodyne Liquid ofHoffman. Even Opium has sometimes been successfully given here, but it should be allowed to Physicians only to direct it in such Cases.A Vomit would be hurtful; and the Reachings to vomit arise only from the Oppression on the Brain.It is a common but erroneous Opinion, that if the Coal be suffered to burn for a Minute or so in the open Air, or in a Chimney, it is sufficient to prevent any Danger from the Vapour of it.Hence it amounts even to a criminal Degree of Imprudence, to sleep in a Chamber whileCharcoal or small Coal is burning in it; and the Number of such imprudent Persons, as have never awaked after it, is so considerable, and so generally known too, that the Continuance of this unhappy Custom is astonishing.§ 526. The Bakers, who make Use of much small Coal, often keep great Quantities of it in their Cellars, which frequently abound so much with the Vapour of it, that it seizes them violently the Moment they enter into the Cellar. They sink down at once deprived of all Sensation, and die if they are not drawn out of it soon enough to be assisted, according to the Directions I have just given.One certain Means of preventing such fatal Accidents is, upon going into the Cellar to throw some flaming Paper or Straw into it, and if these continue to flame out and consume, there is no Reason for dreading the Vapour: but if they should be extinguished, no Person should venture in. But after opening the Vent-hole, a Bundle of flaming Straw must be set at the Door, which serves to attract the external Air strongly. Soon after the Experiment of the flaming Paper must be repeated, and if it goes out, more Straw is to be set on Fire before the Cellar Door.§ 527. Small Coal, burnt in an open Fire, is not near so dangerous asCharcoal, properly so called, the Danger of which arises from this, that in extinguishing it by the usual Methods, all those sulphureous Particles of it, in which its Danger consists, are concentred. Nevertheless, smallCoal is not entirely deprived of all its noxious Quality, without some of which it could not strictly be Coal.The common Method of throwing some Salt on live Coals, before they are conveyed into a Chamber; or of casting a Piece of Iron among them to imbibe some Part of their deadly narcotic Sulphur, is not without its Utility; though by no means sufficient to prevent all Danger from them.§ 528. When the most dangerous Symptoms from this Cause disappear, and there remains only some Degree of Weakness, of Numbness, and a little Inappetency, or Loathing at Stomach, nothing is better than Lemonade with one fourth Part Wine, half a Cup of which should frequently be taken, with a small Crust of Bread.§ 529. The Vapour which exhales from Wine, and in general from all fermenting Liquors, such as Beer, Cyder,&c.contains something poisonous, which kills in the like Manner with the Vapour of Coal; and there is always some Danger in going into a Cellar, where there is much Wine in the State of Fermentation; if it has been shut up close for several Hours. There have been many Examples of Persons struck dead on entering one, and of others who have escaped out of it with Difficulty.When such unhappy Accidents occur, Men should not be successively exposed, one after another, to perish, by endeavouring to fetch out the first who sunk down upon his Entrance; butthe Air should immediately be purified by the Method already directed, or by discharging some Guns into the Cellar; after which People may venture in with Precaution. And when the Persons unfortunately affected are brought out, they are to be treated like those, who were affected with the Coal-Vapour.I saw a Man, about eight Years since, who was not sensible of the Application of Spirit of Sal Ammoniac, till about an Hour after he was struck down, and who was entirely freed at last by a plentiful Bleeding; though he had been so insensible, that it was several Hours before he discovered a very great Wound he had, which extended from the Middle of his Arm to his Armpit, and which was made by a Hook intended to be used, in Case of a House catching Fire, to assist Persons in escaping from the Flames.§ 530. When subterraneous Caves that have been very long shut are opened; or when deep Wells are cleaned, that have not been emptied for several Years, the Vapours arising from them produce the same Symptoms I have mentioned, and require the same Assistance. They are to be cleansed and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as compounded of both.§ 531. The offensive Stink of Lamps and of Candles, especially when their Flames are extinguished, operate like other Vapours, though with less Violence, and less suddenly.Neverthelessthere have been Instances of Peoplekilled by the Fumes of Lamps fed with Nut Oil, which had been extinguished in a close Room. These last Smells or Fumes prove noxious also, in Consequence of their Greasiness, which being conveyed, together with the Air, into the Lungs, prevent their Respiration: And hence we may observe, that Persons of weak delicate Breasts find themselves quickly oppressed in Chambers or Apartments, illuminated with many Candles.The proper Remedies have been already directed,§ 525. The Steam of Vinegar is very serviceable in such Cases.

§ 524. Not a single Year passes over here, without the Destruction of many People by theVapour of Charcoal, or of small Coal, and by the Steam or Vapour of Wine.

The Symptoms by Coal occur, when108small Coal, and especially when109Charcoal is burnt in a Chamber close shut, which is direct Poison to a Person shut up in it. The sulphureous Oil, which is set at Liberty and diffused by the Action of Fire, expands itself through the Chamber; while those who are in it perceive a Disorder and Confusion in their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and very unusual Kind of Numbness; become raving, convulsed and trembling; and if they fail of Presence of Mind, or of Strength, to get out of the Chamber, they die within a short Time.

I have seen a Woman who had vertiginous Commotions in her Head for two Days, and almost continual Vomitings, from her having been confined less than six Minutes in a Chamber (and that notwithstanding, both one Window and one Door were open) in which there was a Chafing-dish with some burning Coals. Had the Room been quite close, she must have perished by it.

This Vapour is narcotic or stupefying, and proves mortal in Consequence of its producing asleepy or apoplectic Disorder, though blended, at the same time, with something convulsive; which sufficiently appears from the Closure of the Mouth, and the strict Contraction or Locking of the Jaws.

The Condition of the Brain, in the dissected Bodies of Persons thus destroyed, proves that they die of an Apoplexy: notwithstanding it is very probable that Suffocation is also partly the Cause of their Deaths; as the Lungs have been found stuffed up with Blood and livid.

It has also been observed in some other such Bodies, that Patients killed by the Vapour of burning Coals, have commonly their whole Body swelled out to one third more than their Magnitude, when living. The Face, Neck, and Arms are swelled out, as if they had been blown up; and the whole human Machine appears in such a State, as the dead Body of a Person would, who had been violently strangled; and who had made all possible Resistance for a long time, before he was overpowered.

§ 525. Such as are sensible of the great Danger they are in, and retreat seasonably from it, are generally relieved as soon as they get into the open Air; or if they have any remaining Uneasiness, a little Water and Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when they are so far poisoned, as to have lost their Feeling and Understanding, if there be any Means of reviving them, such Means consist,

1, In exposing them to a very pure, fresh and open Air.

2, In making them smell to some very penetrating Odour, which is somewhat stimulating and reviving, such as the volatile Spirit of Sal Ammoniac, the110EnglishSalt; and afterwards to surround them, as it were, with the Steam of Vinegar.

3, In taking some Blood from their Arm.

4, In putting their Legs into warm or hot Water, and chafing them well.

5, In making them swallow, if practicable, much Lemonade, or Water and Vinegar, with the Addition of Nitre: and,

6, In throwing up some sharp Glysters.

As it is manifest there is something spasmodic in these Cases, it were proper to be provided with some antispasmodic Remedies, such as the Mineral Anodyne Liquid ofHoffman. Even Opium has sometimes been successfully given here, but it should be allowed to Physicians only to direct it in such Cases.

A Vomit would be hurtful; and the Reachings to vomit arise only from the Oppression on the Brain.

It is a common but erroneous Opinion, that if the Coal be suffered to burn for a Minute or so in the open Air, or in a Chimney, it is sufficient to prevent any Danger from the Vapour of it.

Hence it amounts even to a criminal Degree of Imprudence, to sleep in a Chamber whileCharcoal or small Coal is burning in it; and the Number of such imprudent Persons, as have never awaked after it, is so considerable, and so generally known too, that the Continuance of this unhappy Custom is astonishing.

§ 526. The Bakers, who make Use of much small Coal, often keep great Quantities of it in their Cellars, which frequently abound so much with the Vapour of it, that it seizes them violently the Moment they enter into the Cellar. They sink down at once deprived of all Sensation, and die if they are not drawn out of it soon enough to be assisted, according to the Directions I have just given.

One certain Means of preventing such fatal Accidents is, upon going into the Cellar to throw some flaming Paper or Straw into it, and if these continue to flame out and consume, there is no Reason for dreading the Vapour: but if they should be extinguished, no Person should venture in. But after opening the Vent-hole, a Bundle of flaming Straw must be set at the Door, which serves to attract the external Air strongly. Soon after the Experiment of the flaming Paper must be repeated, and if it goes out, more Straw is to be set on Fire before the Cellar Door.

§ 527. Small Coal, burnt in an open Fire, is not near so dangerous asCharcoal, properly so called, the Danger of which arises from this, that in extinguishing it by the usual Methods, all those sulphureous Particles of it, in which its Danger consists, are concentred. Nevertheless, smallCoal is not entirely deprived of all its noxious Quality, without some of which it could not strictly be Coal.

The common Method of throwing some Salt on live Coals, before they are conveyed into a Chamber; or of casting a Piece of Iron among them to imbibe some Part of their deadly narcotic Sulphur, is not without its Utility; though by no means sufficient to prevent all Danger from them.

§ 528. When the most dangerous Symptoms from this Cause disappear, and there remains only some Degree of Weakness, of Numbness, and a little Inappetency, or Loathing at Stomach, nothing is better than Lemonade with one fourth Part Wine, half a Cup of which should frequently be taken, with a small Crust of Bread.

§ 529. The Vapour which exhales from Wine, and in general from all fermenting Liquors, such as Beer, Cyder,&c.contains something poisonous, which kills in the like Manner with the Vapour of Coal; and there is always some Danger in going into a Cellar, where there is much Wine in the State of Fermentation; if it has been shut up close for several Hours. There have been many Examples of Persons struck dead on entering one, and of others who have escaped out of it with Difficulty.

When such unhappy Accidents occur, Men should not be successively exposed, one after another, to perish, by endeavouring to fetch out the first who sunk down upon his Entrance; butthe Air should immediately be purified by the Method already directed, or by discharging some Guns into the Cellar; after which People may venture in with Precaution. And when the Persons unfortunately affected are brought out, they are to be treated like those, who were affected with the Coal-Vapour.

I saw a Man, about eight Years since, who was not sensible of the Application of Spirit of Sal Ammoniac, till about an Hour after he was struck down, and who was entirely freed at last by a plentiful Bleeding; though he had been so insensible, that it was several Hours before he discovered a very great Wound he had, which extended from the Middle of his Arm to his Armpit, and which was made by a Hook intended to be used, in Case of a House catching Fire, to assist Persons in escaping from the Flames.

§ 530. When subterraneous Caves that have been very long shut are opened; or when deep Wells are cleaned, that have not been emptied for several Years, the Vapours arising from them produce the same Symptoms I have mentioned, and require the same Assistance. They are to be cleansed and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as compounded of both.

§ 531. The offensive Stink of Lamps and of Candles, especially when their Flames are extinguished, operate like other Vapours, though with less Violence, and less suddenly.Neverthelessthere have been Instances of Peoplekilled by the Fumes of Lamps fed with Nut Oil, which had been extinguished in a close Room. These last Smells or Fumes prove noxious also, in Consequence of their Greasiness, which being conveyed, together with the Air, into the Lungs, prevent their Respiration: And hence we may observe, that Persons of weak delicate Breasts find themselves quickly oppressed in Chambers or Apartments, illuminated with many Candles.

The proper Remedies have been already directed,§ 525. The Steam of Vinegar is very serviceable in such Cases.

Of Poisons.§ 532. There are a great Number of Poisons, whose Manner of acting is not alike; and whose ill Effects are to be opposed by different Remedies: But Arsenic, or Ratsbane, and some particular Plants are the Poisons which are the most frequently productive of Mischief, in Country Places.§ 533. It is in Consequence of its excessive Acrimony, or violent Heat and Sharpness, which corrodes or gnaws, that Arsenic destroys by an excessive Inflammation, with a burning Fire as it were, most torturing Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody Vomitings, and Stools, Convulsions, Faintings,&c.The best Remedy of all is pouring down whole Torrents of Milk, or, where there is not Milk, of warm Water. Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable.As soon as ever the tormenting Pains are felt in the Belly, and the Intestines seem attacked, Glysters of Milk must be very frequently thrown up.If at the very Beginning of the Attack, the Patient has a strong Pulse, a very large Bleeding may be considerably serviceable by its delaying the Progress, and diminishing the Degree of Inflammation.And even though it should happen that a Patient overcomes the first Violence of this dreadful Accident, it is too common for him to continue in a languid State for a long Time, and sometimes for all the Remainder of his Life. The most certain Method of preventing this Misery, is to live for some Months solely upon Milk,and some very new laid Eggs, just received from the Hen, and dissolved or blended in the Milk, without boiling them.§ 534. The Plants which chiefly produce these unhappy Accidents are some Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of theBella Donna, or deadly Nightshade, which Children eat by mistake for Cherries; some Kind of Mushrooms, the Seed of theDatura, or the stinking Thorn-Apple.All the Poisons of this Class prove mortal rather from a narcotic, or stupefying, than from an acrid, or very sharp Quality. Vertigos, Faintings, Reachings to vomit, and actual Vomitings are the first Symptoms produced by them.The Patient should immediately swallow down a large Quantity of Water, moderately seasoned with Salt or with Sugar; and then a Vomiting should be excited as soon as possible by the PrescriptionNº. 34or35: or, if neither of these is very readily procurable, with Radish-seed pounded, to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon after forcing a Feather or a Finger into the Patient's Throat, to expedite the Vomiting.After the Operation of the Vomit, he must continue to take a large Quantity of Water, sweetened with Honey or Sugar, together with a considerable Quantity of Vinegar, which is the true Specific, or Antidote, as it were, against those Poisons: the Intestines must also be emptied by a few Glysters.Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the Roots of theOenanthè; or Water-hemlock, became all extremely sick; when the Emetic,Nº. 34, with the Assistance of Glysters, and very plentiful drinking of warm Water, saved all but one of them, who died before he could be assisted.§ 535. If a Person has taken too much Opium; or any Medicine into which it enters, asVeniceTreacle, Mithridate, Diascordium,&c.whether by Imprudence, Mistake, Ignorance, or through any bad Design, he must be bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See§ 147) by Reason that Opium in Effect produces such a one. He should snuff up and inhale the Vapour of Vinegar plentifully, adding it also liberally to the Water he is to drink.

§ 532. There are a great Number of Poisons, whose Manner of acting is not alike; and whose ill Effects are to be opposed by different Remedies: But Arsenic, or Ratsbane, and some particular Plants are the Poisons which are the most frequently productive of Mischief, in Country Places.

§ 533. It is in Consequence of its excessive Acrimony, or violent Heat and Sharpness, which corrodes or gnaws, that Arsenic destroys by an excessive Inflammation, with a burning Fire as it were, most torturing Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody Vomitings, and Stools, Convulsions, Faintings,&c.

The best Remedy of all is pouring down whole Torrents of Milk, or, where there is not Milk, of warm Water. Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable.

As soon as ever the tormenting Pains are felt in the Belly, and the Intestines seem attacked, Glysters of Milk must be very frequently thrown up.

If at the very Beginning of the Attack, the Patient has a strong Pulse, a very large Bleeding may be considerably serviceable by its delaying the Progress, and diminishing the Degree of Inflammation.

And even though it should happen that a Patient overcomes the first Violence of this dreadful Accident, it is too common for him to continue in a languid State for a long Time, and sometimes for all the Remainder of his Life. The most certain Method of preventing this Misery, is to live for some Months solely upon Milk,and some very new laid Eggs, just received from the Hen, and dissolved or blended in the Milk, without boiling them.

§ 534. The Plants which chiefly produce these unhappy Accidents are some Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of theBella Donna, or deadly Nightshade, which Children eat by mistake for Cherries; some Kind of Mushrooms, the Seed of theDatura, or the stinking Thorn-Apple.

All the Poisons of this Class prove mortal rather from a narcotic, or stupefying, than from an acrid, or very sharp Quality. Vertigos, Faintings, Reachings to vomit, and actual Vomitings are the first Symptoms produced by them.

The Patient should immediately swallow down a large Quantity of Water, moderately seasoned with Salt or with Sugar; and then a Vomiting should be excited as soon as possible by the PrescriptionNº. 34or35: or, if neither of these is very readily procurable, with Radish-seed pounded, to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon after forcing a Feather or a Finger into the Patient's Throat, to expedite the Vomiting.

After the Operation of the Vomit, he must continue to take a large Quantity of Water, sweetened with Honey or Sugar, together with a considerable Quantity of Vinegar, which is the true Specific, or Antidote, as it were, against those Poisons: the Intestines must also be emptied by a few Glysters.

Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the Roots of theOenanthè; or Water-hemlock, became all extremely sick; when the Emetic,Nº. 34, with the Assistance of Glysters, and very plentiful drinking of warm Water, saved all but one of them, who died before he could be assisted.

§ 535. If a Person has taken too much Opium; or any Medicine into which it enters, asVeniceTreacle, Mithridate, Diascordium,&c.whether by Imprudence, Mistake, Ignorance, or through any bad Design, he must be bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See§ 147) by Reason that Opium in Effect produces such a one. He should snuff up and inhale the Vapour of Vinegar plentifully, adding it also liberally to the Water he is to drink.

Of acute Pains.§ 536. It is not my Intention to treat here of those Pains, that accompany any evident known Disease, and which should be conducted as relating to such Diseases; nor of such Pains as infirm valetudinary Persons are habitually subject to; since Experience has informed such of the most effectual Relief for them: But when a Person sound and hale, finds himself suddenly attacked with some excessive Pain, in whatever Part it occurs, without knowing either the Nature, orthe Cause of it, they may, till proper Advice can be procured,1, Part with some Blood, which, by abating the Fulness and Tension, almost constantly asswages the Pains, at least for some Time: and it may even be repeated, if, without weakening the Patient much, it has lessened the Violence of the Pain.2, The Patient should drink abundantly of some very mild temperate Drink, such as the PtisanNº. 2, the Almond EmulsionNº. 4, or warm Water with a fourth or fifth Part Milk.3, Several emollient Glysters should be given.4, The whole Part that is affected, and the adjoining Parts should be covered with Cataplasms, or soothed with the emollient Fomentation,Nº. 9.5, The warm Bath may also be advantagiously used.6, If notwithstanding all these Assistances, the Pain should still continue violent, and the Pulse is neither full nor hard, the grown Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of liquid Laudanum; and when neither of these are to be had,111anEnglishPint of boiling Water must be poured upon three or four Poppy-heads with their Seeds, but without the Leaves, and this Decoction is to be drank like Tea.§ 537. Persons very subject to frequent Pains, and especially to violent Head-achs, should abstainfrom all strong Drink; such Abstinence being often the only Means of curing them: And People are very often mistaken in supposing Wine necessary for as many as seem to have a weak Stomach.

§ 536. It is not my Intention to treat here of those Pains, that accompany any evident known Disease, and which should be conducted as relating to such Diseases; nor of such Pains as infirm valetudinary Persons are habitually subject to; since Experience has informed such of the most effectual Relief for them: But when a Person sound and hale, finds himself suddenly attacked with some excessive Pain, in whatever Part it occurs, without knowing either the Nature, orthe Cause of it, they may, till proper Advice can be procured,

1, Part with some Blood, which, by abating the Fulness and Tension, almost constantly asswages the Pains, at least for some Time: and it may even be repeated, if, without weakening the Patient much, it has lessened the Violence of the Pain.

2, The Patient should drink abundantly of some very mild temperate Drink, such as the PtisanNº. 2, the Almond EmulsionNº. 4, or warm Water with a fourth or fifth Part Milk.

3, Several emollient Glysters should be given.

4, The whole Part that is affected, and the adjoining Parts should be covered with Cataplasms, or soothed with the emollient Fomentation,Nº. 9.

5, The warm Bath may also be advantagiously used.

6, If notwithstanding all these Assistances, the Pain should still continue violent, and the Pulse is neither full nor hard, the grown Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of liquid Laudanum; and when neither of these are to be had,111anEnglishPint of boiling Water must be poured upon three or four Poppy-heads with their Seeds, but without the Leaves, and this Decoction is to be drank like Tea.

§ 537. Persons very subject to frequent Pains, and especially to violent Head-achs, should abstainfrom all strong Drink; such Abstinence being often the only Means of curing them: And People are very often mistaken in supposing Wine necessary for as many as seem to have a weak Stomach.

Back to IndexNext